Do the more educated utilize more health care services? Evidence from Vietnam using a regression discontinuity design
In 1991, Vietnam implemented a compulsory primary schooling reform that provides this study a natural experiment to estimate the causal effect of education on health care utilization with a regression discontinuity design. This paper finds that education causes statistically significant impacts on health care utilization, although the signs of the impacts change with specific types of health care services examined. In particular, education increases the inpatient utilization of the public health sector, but it reduces the outpatient utilization of both the public and private health sectors. The estimates are strongly robust to various windows of the sample choice. The paper also discovers that the links between education and the probability of health insurance and income play essential roles as potential mechanisms to explain the causal impact of education on health care utilization in Vietnam.
KeywordsEducation Health care utilization Regression discontinuity design Vietnam
JEL ClassificationI12 I21 J13
The author would like to thank the editor, two anonymous reviewers and Thomas Cornelissen for helpful comments and suggestions.
- Angrist, J. D., & Pischke, J.-S. (2009). Mostly harmless econometrics: An empiricist’s companion. Princeton, NJ: Princeton University Press.Google Scholar
- Cutler, D., & Lleras-Muney, A. (2008). Education and health: Evaluating theories and evidence. In J. House, R. Schoeni, G. Kaplan, & H. Pollack (Eds.), Making Americans healthier: Social and economic policy as health policy. New York: Russell Sage Foundation.Google Scholar
- Dang, T. (2017a). Quasi-experimental evidence on the political impacts of education in Vietnam. MPRA Paper 77641, University Library of Munich, Germany.Google Scholar
- Dang, T. (2017b). Education as protection? The effect of schooling on non-wage compensation in a developing country. MPRA Paper 79223, University Library of Munich, Germany.Google Scholar
- Dang, T. (2017c). The multiple effects of child health insurance in Vietnam. MPRA Paper 78614, University Library of Munich, Germany.Google Scholar
- Grossman, M. (1976). The correlation between Health and schooling. In Household production and consumption. National Bureau of Economic Research, pp. 147–224.Google Scholar
- Grossman, M. (2000). The human capital model. In A. J. Culyer & J. P. Newhouse (Eds.), Handbook of health economics. Amsterdam: Elsevier.Google Scholar
- Grossman, M. (2006). Education and nonmarket outcomes. In E. Hanushek & F. Welch (Eds.), Handbook of the economics of education. Amsterdam: North-Holland.Google Scholar
- Ministry of Health of Vietnam. (2007). Vietnam health care report 2006: Equity, efficiency, and development in new situation. Retrieved December 23, 2016 from: http://jahr.org.vn/downloads/Nghien%20cuu/Khac/Vietnam%20National%20Health%20Report%202006.pdf.
- Ministry of Health of Vietnam and Health Partnership Group. (2008). Joint annual health review 2008. Health financing in Vietnam. Retrieved December 23, 2016 from: http://jahr.org.vn/index.php?option=com_content&view=frontpage&lang=en.
- Thoa, N. T., Thanh, N. X., Chuc, N. T., & Lindholm, L. (2013). The impact of economic growth on health care utilization: A longitudinal study in rural Vietnam. International Journal for Equity in Health, 12(19), 1–6.Google Scholar
- United Nations. (2015). Millennium development goals and beyond 2015. Retrieved December 23, 2016 from: http://www.un.org/millenniumgoals/.
- World Bank. (2007). Vietnam development report 2008: Social protection, joint donor report to the Vietnam consultative group meeting. Hanoi: World Bank.Google Scholar
- World Bank. (2017). The statistics for Vietnam.Google Scholar
- World Health Organization. (2011). Investing in health for Africa: The case for strengthening systems for better health outcomes.Google Scholar
- World Health Organization. (2017). Global health observatory: Vietnam. Retrieved November 21, 2017 from: http://www.who.int/gho/countries/vnm/country_profiles/en/.